Ann Butler Willis, M.S., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

102725 Issued in TX

Practice address

10325 Lanshire Dr
Dallas, TX 75238-3523

Phone

(214) 621-3536

NPI assigned

Jan 16, 2020

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1579132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579132800000",
    "number": "1700416955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10325 LANSHIRE DR",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752383523",
            "telephone_number": "214-621-3536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10325 LANSHIRE DR",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752383523",
            "telephone_number": "214-621-3536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "ANN",
        "middle_name": "BUTLER",
        "name_prefix": "Mrs.",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-16",
        "last_updated": "2020-01-16",
        "certification_date": "2020-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "102725",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ASHA CERTIFICATE NUMBER",
            "identifier": "12127802",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS SPEECH LANGUAGE PATHOLOGY LICENSE",
            "identifier": "102725",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shaniqua Juanita Williamson, PA-C
• Susan W Williamson, MD
• James Willig
• Irene Rae Willingham, M.D.
• Byrd Cicero Willis Pineda, MD, MSC
• Ardelia Willis
• Brandon Willis
• Brittany Louise Willis, CRNA
• Carlota Laneshia Willis, LCSW
• Christina J Willis, LPC

• Speech-Language Pathologist in Dallas, TX
• Providers in Dallas, TX by specialty
• Speech-Language Pathologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.